Thoracic Oncology Service

Adenocarcinoma begins in the alveoli, the cells near the outer wall of the lungs that allow the exchange of oxygen and carbon dioxide.

Patients across the nation, and worldwide, come to the Herbert Irving Comprehensive Cancer Center at New York-Presbyterian/Columbia University Medical Center for truly individualized care.

Recognized by the National Cancer Institute as a designated cancer center, our program provides access to specialists in every discipline, offering the kind of in-depth expertise only possible at a major academic medical institution. Our physicians are global leaders in innovative technologies, genetics, clinical trials and "bench to bedside" research, allowing us to offer the most advanced therapies for lung cancer.

What is lung cancer?

Lung cancer generally occurs when abnormal cells begin to grow in the lungs or in the air passages (bronchi) leading to the lungs. These cells fail to mature normally and create healthy lung tissue. Instead, they grow rapidly and start forming solid masses called tumors. As these tumors get larger and increase in number, they interfere with the lungs’ capacity to do their job - providing oxygen to the bloodstream and eliminating carbon dioxide.

Lung cancer usually takes many years to develop. However, the tissue in the air passages leading to the lung can be altered after exposure to cigarette smoke, or certain cancer-causing substances (carcinogens) in the environment. With constant exposure, the body produces even more abnormal cells, accelerating the disease process. Therefore, the greater the exposure to smoking, the higher the risk of developing lung cancer. However, we also know that lung cancer can develop in never-smokers.

Lung cancer can be cured if diagnosed right away. This usually involves surgery, sometimes combined with other treatment types. But it is often diagnosed at a later stage and requires non-surgical treatment.

Types of lung cancer

There are two major types of lung cancer:

Non-small cell lung cancer (NSCLC): This is the most common type of lung cancer, accounting for about 85% of all cases. NSCLC is divided into three categories based on the cell of origin and the way they look under the microscope:

Adenocarcinoma begins in the alveoli, the cells near the outer wall of the lungs that allow the exchange of oxygen and carbon dioxide.

Squamous cell carcinoma begins in the bronchial tubes, the air passages located in the center of the lungs.

Large cell carcinoma is a term for the 5% of all non-small cell lung cancers that do not clearly fall into the previous groups.

Small cell lung cancers (SCLC). This type of cancer accounts for roughly 10 to 15 percent of all lung cancers. It is named for the size of the cancer cells seen under the microscope. Small cell lung cancer tends to grow more rapidly and is more likely to spread to other organs. Chemotherapy is usually the treatment of choice in SCLC.

Diagnosis of lung cancer

In patients who have a heavy smoking history, early screening with computed tomography (CT) scans can help detect lung cancer at an early stage. Studies have shown that smokers who underwent CT screening had a better survival than those who did not.

If you have a suspicious lesion on imaging, you will need to undergo a biopsy. This can happen several ways:

Bronchoscopy –A minimally invasive procedure involving anesthesia that allows the doctor to take tissue samples directly from the airway.

Endobronchial ultrasound (EBUS) – This is similar to a bronchoscopy, but the scope is guided by ultrasound images and can be used to explore masses located just outside the tubes.

Fine needle aspiration (FNA)/biopsy – Using CT guidance, the doctor inserts a needle into the chest directly to extract tissue sample from the lung

The biopsy is then reviewed by one of our thoracic pathologists, who will then determine whether or not the lesion is cancerous.

Treatment of lung cancer

As each patient and each lung cancer is unique, we develop a treatment plan in a multidisciplinary fashion that is designed especially for your case. Each case is reviewed by our team of lung experts that includes medical oncologists, surgical oncologists, radiation oncologists, and pathologists. The treatment plan may include:

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